For millions of Americans this is the last full week to shop for their 2022 health plan. That includes 4 million-plus current and former federal civil servants in what many consider the best employer-backed health plan in the U.S. the Federal Employee Health Benefits Plan.
Workers and retirees in the DC area have 38 plans and options to choose from. In most other places feds have 20 or more choices. Daunting, to be sure. But not exactly mission impossible.
Good news: All of the FEHBP plans are good. Bad news: Some, for you, are a lot better and less expensive than others. Like the one you are in now.
You may be in the wrong plan if you haven’t changed in years. Or if you are still in the excellent but-expensive high option when its basic or standard option would cover you just as well, at half the premium. Many in the FEHBP could easily save $2000 in premiums next year just by downsizing from the high option to standard or basic.
You may be in the wrong plan if you haven’t checked its catastrophic coverage, the dollar-limit you will have to pay out of pocket if 2022 turns out to be a disastrous year for you and your family. Some plans limit you to a couple of thousand dollars out of pocket. Some are closer to $20,000.
Since open season started we’ve had a series of columns and Your Turn radio shows about best-buys in the FEHBP. The experts have been Walton Francis and Kevin Moss of Checkbooks Guide to Health Plans for Federal Employees. All those columns are archived, as are the regular Wednesday Your Turn shows.
Today is something different. But hopefully, helpful. It’s a 7-step checklist for all insurance hunters — fed and nonfed — compiled by Amy O’Meara Chambers. She’s a health plan expert and COO of HealthBridge. Here’s the general checklist:
1. There is no right answer for everyone.
The best choice of benefit plans will depend on your financial situation, your health, and the needs of any spouses or dependents covered by your plan, among other variables. Since these factors vary greatly from person to person, there is no one-size-fits-all answer to the question of which benefits to choose.
2. There is no such thing as a perfect plan.
Every Open Enrollment choice comes with tradeoffs. Health plans that carry a higher deductible routinely come with lower premiums, for example, while plans with a lower deductible carry higher premiums. Be sure to read the fine print of any plan that sounds too good to be true. It probably is.
3. What are your health needs in a typical year? In 2022?
It’s useful to review where your medical, dental and vision expenses were allocated over the past year. Your provider should make this information readily available online. Some of these are knowable variables, such as the cost of prescription drugs you will continue to use in 2022. Do you have any life events ― a major surgery, perhaps, or the birth of a child ― planned for 2022? If you know you will be spending more than usual in the new year, consider choosing a lower-deductible plan over one with lower monthly premiums.
4. Listen to those (sometimes tedious) HR presentations.
When the choice between two plans isn’t obvious, the answer might emerge in the details. Your employer’s human resources department will likely schedule one or more presentations for employees to review their available benefit offerings in detail. While they might seem long and overly meticulous, these presentations are useful for sifting through detailed information about each plan.
5. Ask questions.
How much will you have to pay out of pocket before your benefits kick in? Do prescription drugs count toward your deductible? What are the costs associated with insuring spouses and dependents? If the answers to questions like these aren’t explicit from your new Open Enrollment documents, ask your human resources department. Someone there might have had a direct role in negotiating the available choices, and can point to the solution that’s best for your unique situation.
6. Take advantage of FSAs and HSAs.
The money you save in a Health Savings Account (HSAs) frequently rolls over from one year to the next, and reduces your tax burden (up to a predetermined limit). The money allocated to Flexible Spending Accounts (FSAs) are available to employees beginning Jan. 1 ― even if it’s deducted from your paycheck over the course of a calendar year. Find out which of these plans is available through your employer, and develop a plan to maximize its effectiveness for your planned 2022 expenses.
7. Enroll in a third-party program to assist with debt.
Some third-party programs, offered alongside standard health plans, exist solely to help employees address the growing national problem of debt related to medical expenses. Some of these programs educate employees on the “financial wellness” of paying for their health costs. Others offer lines of credit that allow patients to get the care they need now, and worry about repayment later. Ask your HR department if any are available to you.
HealthBridge Mention in the Article
Amy O'Meara Chambers, JD
Chief Operating Officer